Indeed, this person is absolutely necessary for the establishment of a metacontingency in which the behavior of one individual determines the contingencies for another. Because both individuals are in long-term recovery – these behaviors both feedback and feed forward to maintain the abstinence of both individuals. Moreover, the larger social network of former users – all of whom are in various stages of recovery – encourage one another via modeling and reinforcement to take “personal inventory” and to identify the personal factors that play a causal role in their drug use. In closed meetings, these factors are shared with others – not as an exercise in vulnerability – but to draw attention to the personal factors that contribute to addiction across individuals. The commonality of these personal factors is often unknown to a person just beginning treatment (hence the commonly invoked phrase, “Thank you for sharing”).

biopsychosocial theory of addiction

Taken together, the findings from these studies suggest that there is growing support for relations among child BMI, social environment variables (media, peer, and parent), and psychological variables and body dissatisfaction in young children. Further research is required to identify the relative roles of these variables and the direction of relations. Psycho-social systems are concrete entities or groups whose members act in relation to each other, such as families, religious organizations, and political parties (Bunge 2004).

What causes addiction?

Most of them started using substances at age 12–15, and heroin or amphetamines were their main substances, combined with cannabis, prescription drugs and alcohol. Letting your friends, family, and those closest to you know about your treatment plan can help you keep on track and avoid triggers. The type of treatment a doctor recommends depends on the severity and stage of the addiction. Later stages may benefit from inpatient addiction treatment in a controlled setting. Many young men are taught to keep things to themselves rather than share their feelings and seek help from a mental health professional. So, they tend to misuse substances that make them feel better, even if only temporarily.

The internal homunculus is a fallacy – it has no role in either the production or evaluation of behavior or its consequences. Rather, social learning theory argues that personal factors, including the cognitively derived “self”, play a deterministic role in the production of behavior. Thus, behavior is fully determined, but personal factors in the form of intentionality, forethought, self-reactiveness, and self-reflectiveness are just as causal determinants of behavior as contingencies that operate in the environment. Borrowing from Bandura’s model, “drug use” can be considered the critical behavior of interest. Both personal factors internal to the individual and environmental factors external to the individual directly impact the likelihood of using drugs. Moreover, all three of these factors mutually influence one another, leading to continually evolving functional relationships that both directly and indirectly influence the use of drugs (Figure 1B).

Interdisciplinary Professional Support

An argument is thus constructed that emphasizes the need for an organized structure of metacontingencies, operating within an individual’s social environment, that targets the functional relationships between the factors that drive drug use. According to this model, the non-eliminable dimensions of addiction are those that relate to the act of using drugs, the personal characteristics of the user, and the contingencies operating in the environment, particularly the social environment. These dimensions, which operate at different levels, interact with one another to produce differences in drug use across individuals. In a similar fashion, a person’s current environment directly impacts the likelihood of using drugs by setting the contingencies that influence drug use. Of most importance, however, is the social environment, which acts to either encourage or discourage drug use. Drug use may be transmitted socially by a number of mechanisms (Strickland and Smith, 2014; 2015), and several of these mechanisms have received empirical support.

Psychologists would later argue that this type of selection works primarily at the level of the individual. It is adaptive for both the species and the individual to act in ways that bring pleasure – such as approaching palatable food or a sexually receptive mate. Moreover, it is adaptive at How to Stop Drinking Out of Boredom both the species and individual level for the organism to avoid those situations that can cause illness, anxiety, or despair. In the 25 years that have elapsed since Engel first proposed the biopsychosocial model, two new intellectual trends have emerged that could make it even more robust.

Biopsychosocial Model of Addiction

When neurogenetic attributions are presented in the clinic, pharmacological treatments are often believed to be a more effective option over psychotherapy (Phelan, Yang, and Cruz-Rojas 2006). This attribution could sway those who assign the cause of their addiction to be exclusively neurological or genetically based, and not necessarily evaluate the risks and benefits of pharmacotherapy, psychotherapy, or receiving both as combination. These causal neurogenetic attributions have led some authors to advocate for involuntary treatment in addiction, arguing that, paradoxically, autonomy must be denied, “in order to create it” (Caplan 2008). Rates of substance use and dependence vary across, and even within, cultural and social groups (Wallace 1999; Wallace, Bachman, O’Malley et al. 2002). Factors such as availability and peer modeling account for the inter- and intra-group disparities (Thomas 2007). These factors may indicate a certain level of group risk for problematic substance use, but cannot verify either the likelihood of substance use occurring within the group or which individuals within the group are more likely to be affected.

  • The internal homunculus is a fallacy – it has no role in either the production or evaluation of behavior or its consequences.
  • Such writings would later inspire the work of several British Empiricists, who took Aristotle’s emphasis on sensory experience and associationism to its logical extremes.
  • This can be individual, family, peer and community.(30) Substance use may be familial, a person may have watched a parent or caretaker use alcohol on special occasions or more frequently.
  • AA and NA are not for everyone, and a number of reasons have been given by individuals who left these programs voluntarily while still in recovery (e.g., the emphasis on religiosity; Kelly et al., 2011).

A biopsychosocial systems approach does not portray people as only controlled by the state of their brains. Addictive behaviours are neither viewed as controlled or uncontrolled but as difficult to control a matter of degree. Further, the clinically observed defining feature of addiction a loss of control is understood as a socially normative notion. Thus the claim that “an addict cannot be a fully free autonomous agent” (Caplan 2008, p.1919) is debatable. Because of a tendency to focus on extreme pathological states, the wide range of normal is often forgotten. Socrates was a nativist, as revealed by his insistence that it was human nature to select the virtuous option.

Theory Comparison

It is perhaps the transformation of the way illness, suffering, and healing are viewed that may be Engel’s most durable contribution. The practical application of the biopsychosocial model, which we will call biopsychosocially oriented clinical practice does not necessarily evolve from the constructs of interactional dualism or circular causality. Rather, it may be that the content and emotions that constitute the clinician’s relationship with the patient are the fundamental principles of biopsychosocial-oriented clinical practice, which then inform the manner in which the physician exercises his or her power. The models of relationship that have tended to appear in the medical literature, with a few notable exceptions,19 have perhaps focused too much on an analysis of power and too little on the underlying emotional climate of the clinical relationship. These approaches represent movement toward an egalitarian relationship in which the clinician is aware of and careful with his or her use of power. Serious complications can cause health concerns or social situations to result in the end of a life.

biopsychosocial theory of addiction

The good news is that scientists are actively pursuing many more paths to treatment and prevention of these complex illnesses. We already mentioned how addiction could be triggered when one suffers from a mental health disorder. It is very common for young men who feel sad, depressed, anxious, and stressed out to turn to alcohol or drugs. Recovery from addicction is a difficult path, but millions of people have recovered. Different tools provided by programs like Alcoholics Anonymous and Narcotics Anonymous have helped many people. Therapy also helps with people assisting people to get to the root causes of their addiction and learn new coping skills for managing their mental health.

The Biopsychosocial Model and Its Limitations

These new contingencies, in turn, impact the behavior of all individuals within the social network. They also influence the individual by influencing cognitive appraisals of both their behavior and their social network. The informants expressed strong emotions when talking about the close relationships in their lives. They either spoke about their parents as ‘betrayers’ and ‘bastards’ or as loving and supportive people. Siblings, grandparents, aunts, and uncles often represented stability and safety in families with parental SUD or mental health problems. Furthermore, some communities are targeted more heavily with alcohol and tobacco advertisements and have more availability of drugs of abuse than others, particularly impoverished communities (Primack et al., 2007; Rose et al., 2019).

Fortunately, there are different treatment tools and methods available to help along the way, such as sober living homes, Alcoholics Anonymous, and a therapeutic approach called the biopsychosocial model of addiction. When you get sober, you hear that you need to change people, places, and things. One of the primary reasons that addiction persists and relapses happen is because of the people you keep in your life or the situations that you need to get out of.

One explanation for this trend is that the toxic stress from trauma leads to a dysregulated stress response. An individual’s stress hormones (cortisol and adrenaline) are chronically elevated (Burke Harris, 2018; van der Kolk, 2014). Some people may try a substance or behavior and never approach it again, while others become addicted.